Nicole Yvonne Agan, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW22118 Issued in AZ

Practice address

305 E Cherry Ave Ste 205
Flagstaff, AZ 86001-4626

Phone

(928) 605-3497

NPI assigned

Mar 8, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peak Potential Therapy

  • Adult Mental Health Clinic/Center
  • Flagstaff, AZ
  • NPI 1285448241
  NPD Authorized official
• Redemption Counseling Center

  • Professional Counselor
  • Flagstaff, AZ
  • NPI 1801431952

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736640000000",
    "number": "1255199840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E CHERRY AVE STE 205",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014626",
            "telephone_number": "928-605-3497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E CHERRY AVE STE 205",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860014626",
            "telephone_number": "928-605-3497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGAN",
        "first_name": "NICOLE",
        "middle_name": "YVONNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-08",
        "last_updated": "2025-01-12",
        "certification_date": "2025-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW-22118",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW22118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cynthia Adson, ARNP, FNPBC
• Advanced Anesthesia Group, LLC
• Adventure Discovery Inc
• Michelle R Aerni, D.O.
• Aero Vista Inc
• Agassiz Healthcare Supply Inc.
• Amit Agrawal, M.D.
• Michael Mushtaq Ahmed, EDD.CCC-SLP
• Aigi Care LLC
• Akdhc, LLC

• Clinical Social Worker in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Clinical Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.